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John Kulp
Director of Business Development
Strickler Agency Inc.
 Producer Consulting = Human Capital
Management
 Surround Yourself w. Knowledgeable Partners
& Trusted Advisors
 Team Approach
 Back Office Support w. Extension(s) of your
HR Team
 Efficient Tracking Tools & Resources
 Can no longer visit your health plan annually
 HIM Notices disbursed by 10-1-2013
 Early Renewal Option(s)
 Exchanges (SHOP as well) Open October 1st
 SBC’s (updates as of 1-1-2014)
 PCORI Fees
 90 Day Max Waiting Period
 Cobra Notices/Audits
 OOP Max Limits/Limited Benefit Designs
=$2000/$4000 Small Group Deductible Max.
=$$6350/$12,7000 Large Group OOP Max.
 Adjusted Community Rating (ACR)
 Individual Mandate
 “Itemized Billing” – Small Groups
-Composite vs. Non-Composite Rates
 Employer Mandate/Employer Shared
Responsibility
 30 hrs./week max. eligibility std.
 Employer Reporting to IRS & HHS (Section
6056 under IRS) & Annual EE Statements
 W-2 reporting for all size groups
 Transitional Re-Insurance Fees (ASO)
 Wellness Enhancements
1)Activity Only (participation only)
2)Outcomes Based (ex. Maintain weight)
3)Rewards to not to exceed 30% of total
cost, 50% for tobacco usage control
 Small Employer Tax Credit (SHOP)
 Automatic Enrollment for Large Groups (200+
Full Time) in 2015
 Tiered Networks & Possible Provider Fall-Out
091813 ppaca slide deck   kulp

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091813 ppaca slide deck kulp

  • 1. John Kulp Director of Business Development Strickler Agency Inc.
  • 2.
  • 3.  Producer Consulting = Human Capital Management  Surround Yourself w. Knowledgeable Partners & Trusted Advisors  Team Approach  Back Office Support w. Extension(s) of your HR Team  Efficient Tracking Tools & Resources  Can no longer visit your health plan annually
  • 4.  HIM Notices disbursed by 10-1-2013  Early Renewal Option(s)  Exchanges (SHOP as well) Open October 1st  SBC’s (updates as of 1-1-2014)  PCORI Fees  90 Day Max Waiting Period  Cobra Notices/Audits  OOP Max Limits/Limited Benefit Designs =$2000/$4000 Small Group Deductible Max. =$$6350/$12,7000 Large Group OOP Max.  Adjusted Community Rating (ACR)  Individual Mandate
  • 5.
  • 6.  “Itemized Billing” – Small Groups -Composite vs. Non-Composite Rates  Employer Mandate/Employer Shared Responsibility  30 hrs./week max. eligibility std.  Employer Reporting to IRS & HHS (Section 6056 under IRS) & Annual EE Statements  W-2 reporting for all size groups  Transitional Re-Insurance Fees (ASO)
  • 7.
  • 8.  Wellness Enhancements 1)Activity Only (participation only) 2)Outcomes Based (ex. Maintain weight) 3)Rewards to not to exceed 30% of total cost, 50% for tobacco usage control  Small Employer Tax Credit (SHOP)  Automatic Enrollment for Large Groups (200+ Full Time) in 2015  Tiered Networks & Possible Provider Fall-Out